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P Kemeter

Publications and source records attributed to P Kemeter.

69 records · Page 4Linked to original sources
PubMed1978

[Hormone profiles and hormone therapy in early pregnancy (author's transl)].

Hormone profiles in early pregnancy were established in 67 women and correlated to simultaneously performed ultrasonic examinations. Normal values for human chorionic gonadotropin (HCG), human chorionic somatotropin (HCS), oestradiol (E2) and progesterone (P) were established from the data obtained in 30 early pregnancies which culminated in the birth of a living child. Lowered HCG values were found in 17 out of 23 pregnancies which ended in miscarriage. In these cases ultrasonic examination failed to detect any heart action. Lowered HCS values after the 9th week of pregnancy are also certain proof of missed abortion. P and E2 values are shown to be a parameter reflecting activity of the corpus luteum graviditatis. In clomiphene- and gonadotropin-induced pregnancies higher values were found than in pregnancies managed by substitution treatment with twice weekly 10 mg oestradiolvalerianate + 500mg 17alpha-hydroxyprogesteronecapronate. Lowered P and E2 values with HCG values in the normal range indicate imminent insufficiency of the corpus luteum graviditatis. Pros and cons of hormonal therapy in early pregnancy are discussed.

Abortion, Missed↗
PubMed1978

Further investigations on the maturation and degeneration of human ovarian follicles and their oocytes.

Human ovarian follicles showed activity of alkaline phosphatase, acid phosphatase (AcP) leucine aminopeptidase, and lactate dehydrogenase (LDH) in the theca interna. The granulosa of nonovulatory tertiary follicles showed moderate activity, whereas that of preovulatory Graafian follicles showed strong activity of LDH and AcP. The activity of these enzymes in the follicular fluid was measured. In nonovulatory tertiary follicles, activity of 3beta-ol-steroid dehydrogenase (3beta-OHSD) was found only in the theca interna; their fluid contained 290 ng/ml of progesterone and 502 ng/ml of 17beta-estradiol (average). Preovulatory Graafian follicles showed activity of 3beta-OHSD in the theca as well as in the granulosa. The progesterone concentration of the fluid was 7037 ng/ml and the 17beta-estradiol concentration was 2800 ng/ml (average). More oocytes could be aspirated from ovaries of younger women than from those of older women. In both age groups one out of three oocytes was degenerated. Oocytes with preovulatory changes were found only in follicles with preovulatory changes in their walls. Degenerated oocytes were found in some nonovulatory follicles as well as in some follicles with preovulatory changes in their walls.

Alkaline Phosphatase↗
PubMed1977

[The clinical value of radioimmunological oestradiol assays in the diagnosis of menstrual disorders. Evidence suggesting the presence of an ovarian "inhibin" (author's transl)].

The radioimmunoassay of oestradiol 17 beta (E2) from the blood without chromatography was evaluated in regard to the diagnosis of menstrual cycle disturbances. Two significantly different classes were distinguished, viz. 1. Women with higher E2 values, consisting of three groups: normal controls, cases of oligomenorrhoea, and WHO II (normogonadotropic, clomiphen-positive amenorrhoea). 2. Women with lower E2 values, consisting of two groups: WHO I (hypogonadotropic, clomiphen-negative amenorrhoea) and WHO III (hypergonadotropic amenorrhoea). Within these classes no significant differences were found between the groups. Only values below 43.1 pg/ml can be assigned with 95% certainty to the low-value class and only values above 108.8 pg/ml can be assigned with 95% certainty to the high-value class. The fact that 40% of all E2 values in hypergonadotropic, (i.e. ovarian) amenorrhoea fell within the range of the double standard deviation of the normal group and, likewise, the fact that physiological doses of oestrogen cannot reduce postmenopausal FSH to the level found in women of reproductive age suggest that E2 is not the only FSH-reducing factor, which leads us to postulate the existence of an ovarian "inhibin".

Adult↗
PubMed1977

Response of gonadotropins to stimulation with luteinizing hormone -- releasing hormone (LH-RH) in children with precocious puberty before, during and following therapy with cyproterone acetate or an ethisterone derivate.

9 children with precocious puberty were treated over a period of 6 months to 6 3/12 years with Cyproteron acetate or an Ethisterone derivate. LH-RH tests with radioimmunological estimations of LH and FSH were performed before therapy was begun, during and after completion of treatment. In children with untreated precocious puberty the mean basal LH levels were the same as in normal prepubertal children but the increase and the peak values after i.v. LH-RH were found to be considerably greater than in normals. In the treated patients this stimulatable LH release was suppressed; after completion of therapy it was again elevated. The basal FSH levels in untreated children were elevated; however the increase and the peak values were comparable to the collective norm. Results were not altered considerably by therapy, however these parameters were given elevated after completion of therapy. Despite the marked suppression of stimulatable LH by therapy acceleration of bone age is practically not affected. After completion of therapy this drug-induced suppression of gonadotropines is promptly reversible.

Age Determination by Skeleton↗
PubMed1975

[The post partum administration of quingestanolacetate 0.3 mg as oral contraceptive (author's transl)].

Quingestanolacetate (0.3 mg daily), as from the second week post partum was given to 13 women for a total of 111 therapeutic cycles of 28 days. In addition to clinical follow up, 8 women were subjected to serial pregnanediol determinations in the night urine every other day for a total of 45 cycles. One woman became pregnant in the 5th therapeutic cycle, demonstrating an insufficient contraceptive effect of this minipill. The only major side effect was the occurrence of irregular episodes of bleeding during the first 3 therapeutic cycles. With increasing duration of the administration of this drug, the vaginal bleeding settled down to approximately 7 days per 28 days. When pregnanediol serial determinations were started in the 4th to 6th therapeutic cycle post partum, 6 out of 8 women showed ovulatory cycles. In the two remaining patients ovulatory cycles were observed in the 7th and 10th therapeutic cycle, respectively. Of 45 cycles in which control pregnanediol serial determinations had been undertaken, 11 (25%) were anovulatory, 21 (46%) showed a normal ovulatory excretion pattern and 13 (29%) showed severe luteal insufficiency. An insufficiency of luteal function appears to be partially responsible for the contraceptive effect of this minipill.

Adult↗
PubMed1975

Ovulation inhibition with human chorionic gonadotrophin.

Eight women with regular menstrual cycles were treated daily during 9 cycles with HCG (Human Chorionic Gonadotrophin) 3000 or 5000 IU daily for a period of 4-7 days. This treatment was started between the 1st and the 6th day after the onset of menstruation. Control of the treatment cycles was performed by basal body temperature, pregnanediol serial estimations, endometrial biopsies and in addition in 5 treatment cycles by radio-immunological assay of estradiol-17 beta (Oe2), progesterone, LH and FSH from the serum at intervals of 1 to 3 days. In 6 of these cycles where treatment started on the 4th day or later, ovulation was inhibited (2 cycles) or postponed (4 cycles) to the 24th-46th day. In these 6 treatment cycles the progesterone and pregnanediol increase during HCG treatment was poor or absent. The typical Oe2 increase of the normal menstrual cycle was impaired. In the 3 remaining cycles where treatment was started on the 1st, 2nd and 4th day, we observed during HCG treatment increases in Oe2 and progesterone serum values similar to that found during corpus luteum activity, and menstruation from a secretory endometrium between the 13th-19th day of the cycle. The histologically examined ovaries of one woman who was treated with HCG from the 2nd to the 6th day of the cycle showed distinct luteinization of the theca interna of all tertiary follicles and a beginning degeneration of the granulosa. These findings give support to the hypothesis that the luteinization of the theca interna leads to degeneration of the tertiary follicles thereby causing ovulation inhibition or postponent of ovulation.

Adult↗
PubMed1975

Progesterone, oestradiol-17 beta and testosterone levels in the follicular fluid of tertiary follicles and Graafian follicles of human ovaries.

Radioimmunoassays of testosterone (T), oestradiol-17 beta (Oe2) and progesterone (P) in the fluid of a total of 47 follicles of different degrees of maturity gave the following mean values: T: 49 ng/ml, Oe2: 932 ng/ml, P: 999 ng/ml. In normal, atretic and cystic tertiary follicles not larger than 1 cm and without luteinized theca interna the following mean values were calculated: T: 54 ng/ml, Oe2: 502 ng/ml, P: 368 ng/ml. In six women mature and less mature follicles were compared, the former having significantly higher Oe2 and higher P values but significantly lower T values than the latter. Genuine Graafian follicles were observed four times, once after HMG stimulation; the values observed lay within the following ranges: T: 12-35 ng/ml, Oe2: 1900-4100 ng/ml, P: 156-6000 ng/ml. The difference in concentration compared with cubital-vein blood before ovulation was highest for Oe2, suggesting a particularly marked aromatinzing activity of the follicles of that phase of the cycle. The findings suggest that in the course of accelerated follicular ripening prior to ovulation both the aromatizing enzyme and 3 beta-hydroxysteroid-dehydrogenase are activated, resulting in a sharper rise in Oe2 and P. The profuse production of P causes a transistory lack of precursors for androgen and oestrogen production (T and Oe2 declines). In the course of an overall increase in steroid production during the luteal phase - which probably goes hand in hand with an increased supply of pregnenolone - there is not only a pronounced rise in progesterone but also a moderate increase in oestrogen production. The androgens are transformed more rapidly into oestrogens on account of the marked activity of the aromatizing enzyme in the corpus luteum and thus show a decline in the luteal phase.

Adult↗
PubMedDate not supplied

A fixed stimulation protocol for in vitro fertilization (IVF) without determinations of hormones in blood.

A new fixed schedule of ovarian stimulation for IVF was developed, which is not only simpler and easier to handle for the patients but also yields better fertilization and pregnancy rates. The period and beginning of stimulation are shifted by means of a contraceptive pill, so that stimulation can generally be started on a Sunday. The patient takes 100 mg clomiphene for 5 days and 7.5 mg prednisolone for 30 days to suppress possible exaggerated adrenal androgens; she also receives 150 IU of human menopausal gonadotropin (HMG) i.m. every other day from her family physician. From the 8th day of stimulation onwards, follicular growth is registered by daily ultrasound at the IVF center. When the dominant follicle exceeds 18 mm in diameter, 5000 IU human chorionic gonadotrophin (hCG) is given. Blood sampling for hormone estimations is not necessary, and only one sample of urine is needed for the LH estimation before hCG. In comparison to clomiphene citrate (Clomid) alone, Clomid plus HMG/FSH and HMG/FSH alone, this protocol resulted in significantly higher fertilization and pregnancy rates per follicular puncture. The rate of abortions and extrauterine pregnancies, on the other hand decreased. When comparing repetitive IVF cycles with the first IVF cycle, a significant reduction of oocytes in repetitions was found, but no difference was found in the number of fertilized eggs. The pregnancy rate, on the other hand, increased in the repeat cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Protocols↗
PubMedDate not supplied

Monitoring of Clomid-hMG-hCG controlled ovulation by ultrasound and a rapid (15 minutes) total urinary estrogen assay.

A simple and rapid assay for estimation of total urinary estrogens is presented. The test is based on a commercial latex agglutination inhibition assay designed for urinary estrogens in pregnancy. To obtain the appropriate sensitivity range for the application of the test it was necessary to concentrate the urine using self contained C 18 mini cartridges. A fairly good correlation was found between the obtained values from the urine and estradiol-17 beta estimated by radio-immunoassay in serum (correlation coefficient r = 0,77). Comparing those results and regarding the number of follicles present at ultrasonic examination, and/or laparoscopy a value of 23,79-31,29 mg/l TE in urine/follicle was calculated according to 300-400 pg/ml serum/follicle, at which ovulation should be induced. Even withstanding the inherent limitations of this semiquantitative test and some loss of precision in terms of absolute values, when combined with ultrasound, excellent guidelines were established by this rapid and simple test to determine ovulation induction by hCG.

Chorionic Gonadotropin↗
PubMedDate not supplied

The importance of the FSH/LH ratio in ovarian stimulation therapy regime for in vitro fertilization.

In a retrospective study batches of hMG with different FSH/LH ratios, as well as pure FSH were used in two different stimulation protocols (Clomiphene/hMG and hMG only). The aim of this paper was to study the effect and importance of the different FSH/LH ratios if any, in ovarian stimulation during the follicular phase on the success of IVF. The results of our preliminary study indicate that as far as ovarian stimulation with Clomiphene/hMG is concerned, there seems to be no significant beneficial effect on IVF success of using pure FSH or gonadotropin preparations with higher FSH/LH ratios. With gonadotropin only for ovarian stimulation however, the use of high FSH/LH ratio seems to significantly increase the pregnancy rate.

Clomiphene↗
PubMedDate not supplied

A simplified technique for fertilization and culture of human preimplantation embryos in vitro.

The paper describes simplification of existing methods of culture in human IVF. Focusing attention on the need to streamline procedures, the mode of housing the egg/embryo in a constant accessible environment is examined. We now culture with B2/B3-Menezo medium in a multidish under 5% CO2 in air at 37 degrees C in an open system within a CO2 gassing incubator. The advent of the multidish as a specific housing system is highlighted. The 80% fertilization rate combined with a stable osmolarity demonstrates that previous success is maintained with changes introduced to improve convenience and simplicity of procedures.

Adult↗
PubMedDate not supplied

[A fast (3 minutes) latexagglutination inhibition test for semiquantitative determination of urinary estriol in pregnancy (author's transl)].

Urine samples from 176 healthy women between 29th and 40th week of gestation were analyzed by a test kit. Estrotec Slide Test, which offers a simple and fast test performance for estriol in pregnancy urine. The mechanism of this test system is based on a competitive latex agglutination inhibition reaction. The correlation between Estrotec Slide Test and estriol levels assayed in the same urine samples by a chemical method was r = 0,83. Variation of estriol determinations from urine and estriol levels in serum samples of women at the end of gestation measured by a radioimmunologic method was about 20% for all test principles examinated. The Estrotec Slide Test was proved to be a fast, semiquantitative method. The simple assay procedure itself imposes limits to the information available from it.

Estriol↗